Contributor: Gordon K. Klintworth
Secondary open angle glaucoma is a form of secondary glaucoma [glaucoma - secondary] in which the anterior chamber angle is open, but in which the aqueous humor-outflow and trabecular meshwork is occluded by a variety of cells and debris. The occluding cells and debris include blood [glaucoma - hemorrhagic], blood breakdown products [glaucoma - hemolytic, glaucoma - ghost cell], macrophages containing ingested degenerated lens material [glaucoma - phakolytic], melanosomes from necrotic tumors [glaucoma - melanomalytic, glaucoma - melanocytomalytic], and basement membrane like material from the pseudoexfoliation syndrome [glaucoma - capsular]. Secondary open angle glaucoma also occurs in the Posner-Schlossman syndrome. Other abnormalities in eyes with glaucoma relate to the effects of elevated intraocular pressure such as the abnormalities of the retina, optic nerve, cornea, and sclera. Because the underlying disorder is usually limited to one eye, secondary open angle glaucoma is usually unilateral. Melanin released from the iris pigment epithelium by an abrasion from the zonules accumulates in the trabecular meshwork as in the pigment dispersion syndrome. The pseudoexfoliation syndrome is a relatively common cause of secondary open angle glaucoma in elderly patients and a capsular glaucoma occurs in many patients with this entity. Long term use of topical or systemic corticosteroids results in corticosteriod glaucoma [glaucoma - corticosteroid] from raised intraocular pressure and signs similar to those of primary open angle glaucoma [glaucoma - primary open angle].